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PULSEThe IFMSA Asia Pacific MagazineMarch 2012

Youth and Social Determinants of Health


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IFMSAwas founded in May 1951 and is run by medicalstudents, for medical students, on a non-profitbasis. IFMSA is officially recognised as a non-governmental organisation within the UnitedNations system and has official relations with theWorld Health Organisation. It is the international

forum for medical students, and one of the largeststudent organisations in the world.

is to offer future physicians a

comprehensive introduction toglobal health issues. Throughour programs and opportunities,we develop culturally sensitivestudents of medicine, intent on

influencing the transnationalinequalities that shape the healthof our planet.T

hem

issionofIFMSA

Imprint

Editor in ChiefMariam Parwaiz, New Zealand

Regional Co-ordinatorRenzo Guinto, Philippines

EditorsAirin Aldiani, Indonesia

Design/LayoutAirin Aldiani, Indonesia

ProofreadingMariam Parwaiz, New ZealandAirin Aldiani, IndonesiaTheo Dapamede, Indonesia

PublisherInternational Federation ofMedical Students Associations

General Secretariat:IFMSA c/o WMAB.P. 6301212 Ferney-Voltaire, FrancePhone: +33 450 404 759Fax: +33 450 405 937Email: [email protected]

Homepage: www.ifmsa.org

[email protected]


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ContentsA Message from the Regional Coordinator

Editorials

Theme Article: Act on Social Determinant of Health

IFMSA Asia Pacific Region and AMSA-Philippines

hold Confab towards Transformative MedicalEducation

International Conference: 2nd Health Professional

Education Quality

Putting Patients Safety First

NZMSA Conference 2012

Social Determinant of

Health

IndiaWrite for our May Issue!

4

5

6-7

NMO Updates!

Conference Report

10

11

8-9

12 13-14

1615

Role of Future Healthcare

Professional in Advocacyand Policy

16

Be A Part of Us! 17


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ly in the medical career ladder; in short in medical school.

Address the determinants that shape us. The determi-

nants view of health recognizes that some determinants

are affected by other determinants as well. Medical students

are influenced by other factors, most of them seem large

and difficult to tackle, such as the curriculum design in medi-

cal schools or state policies that govern deployment of med-

ical students after graduation. Medical students must work

hand in hand and become deeply involved in efforts that aim

to transform policies in health care, from the way we produce

our health workers to the way we deliver health services.

Join the worldwide movement for action on social deter-

minants. Oftentimes, we think that there are other chances

in life for us to positively contribute to the world, and student

life is not one of them. This time, you may feel discouraged

because of a sense of inadequacy or burned out because

of the voluminous reading materials, but you should never

underestimate the capacity of young people to change com-munities and transform the world. Medical students should

not miss this exciting opportunity to change the world for

the better at such a grand scale. Today, more and more or-

ganizations from government, private sector, and academia

are rising up to the challenge of closing the health gap in

our generation, and IFMSA should also step into the ring.

Some say that action on social determinants of health is

beyond the confines of medicine. I always tell my fellow medi-

cal students that I am not asking all of them to become

public health practitioners, but I am asking all of them

not to partake in the further widening of health inequities.

We physicians are the natural attor-neys of the poor, according to the great Ger-man physician Rudolf Virchow. It is unacceptable for us

young doctors to surrender this noble responsibility and

instead become accomplice in spreading health injustice.

a message from theregional coordinator

Medical Students as

Social Determinants of Health

R.G. is your RC!

Good day IFMSA Asia-Pacific family! I am deeply elated to open

this issue of the Pulse that focuses on social determinants of

health, as our regions contribution to this years March Gen-

eral Assembly in Accra, Ghana, which will revolve around the

themeYouth and Social Determinants of Health

I am sure that most of our readers are aware that your

Regional Coordinator has been involved in IFMSAs workon social determinants since the very beginning. It was

AMSA-Philippines, in partnership with the Norwegian Medi-

cal Students Association, that proposed the policy state-

ment on social determinants of health and health inequity

during the 2011 March General Assembly in Jakarta.

Before I became Regional Coordinator, I was appointed

facilitator of the Small Working Group on Health Inequi-

ties which led activities pertaining to social determinants,

from the forum with Professor Sir Michael Marmot, the

head of the WHO Commission on Social Determinants

of Health, during our 60th anniversary General Assem-bly in Copenhagen, to the online educational campaign

Root Out, Reach Out. These efforts culminated in our

stellar presence at the World Conference on Social De-

terminants of Health in Rio de Janeiro last October.

Now, after trying to tackle the many social determinants

that affect peoples health, let me digress a bit and discuss

us medical students as important social determinants

of health. For months, we have been involved in campaigning

for a social determinants approach to health, but we have

not yet discussed ourselves as social determinants. Below

I list three initial tips on how medical students can become

powerful social determinants towards better health for all.

Reflect on what we think and do as medical students. We

dont notice it, but the things we do as medical students,

from the way we study to the opportunities we use to apply

theoretical skills, determine the health of our patients and

the shape of the health care system. We will certainly carry

the ideas that we cultivate as early as now, from our under-

standing of health and our beliefs on certain health issues

such as the financing of health or the education of physicians,

as we mature in the health system. Our attitudes towardspatients even during internship may make or break their

physical and even emotional well-being.One of WHO Com-

missions recommendations is to start interventions early

in life, and the same can be said for medical students posi-

tive changes in mindset and attitudes should also begin ear-

Ramon Lorenzo Luis R. Guinto

Regional Coordinator for the Asia-Pacific

International Federation of Medical Students Associations

Renzo


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Editorial

Thanks to our contributors:

Rennie Qin, New ZealandJoanna Choa, PhilippinesShela Sundawa, Indonesia

Christopher Halimkesuma, IndonesiaKen Ip, New ZealandPratap Naidu, India

Rudolf Kuhn, Philippines

Greetings, Kia ora, Salaam, Namaste, Ni Hao, Selamat, Konnichiwa, S-wt-dee and Kumusta!

Welcome to the first issue of Pulse for 2012! Pulse isthe official magazine of the IFMSA Asia-Pacific region.It comes out every two months and as always this issueis jam-packed with articles that will be of interest to ourreaders the medical students from around Asia-Pacific!

The theme for this issue is Youth and Social Determinants

of Health, the same as the theme for IFMSAs MarchMeeting in Ghana happening right now. The socialdeterminants of health have been known for a longtime. But the recent publications from the World HealthOrganizations Commission on Social Determinants ofHealth have added new life into the cause and it is nowgaining further momentum. As the youth of today, andfuture physicians of tomorrow, we have an importantpart of play in ensuring health equity for all.

We have an excellent issue in store for you. Shela PutriSundawa from Indonesia shares her thoughts on whatwe can do to act on the social determinants of healthon page 6. Rennie Qin who is the Development As-sistant for Advocacy, Policy and Education for IFMSAAsia-Pacific explains what advocacy means for our pro-fession and how you can contribute. One great way isby joining the IFMSA Asia-Pacific Think Tank on globalhealth advocacy.

Mariam Parwaiz Airin AldianiDevelopment Assitant for Publications &Communications IFMSA Asia Pacific

We have three conference reports from recent eventsthat medical students have attended in the Asia-Pacificregion. If youve attend a conference or workshop re-cently, we would love for you to write about your ex-perience for Pulse. NZMSA-New Zealand is hostinga conference in May and it is inviting international del-egates to attend the event. You can read more about it

on page 12.

This issue we introduce you to one of our newest NMOs India. Look out in upcoming issues for more NMOupdates to hear about what is happening in the region.

Pulse is your magazine and we value your contribu-tions. There are many ways you can be a part of us.You can write an article for us, or help us as part of theeditorial team, or you can contribute to our newest seg-ment called Whats Up Asia-Pacific?! This is an infor-mal way to share your ideas and opinions with us. Wewant to hear from you and find out what is happeningin your part of the region. As always, please feel free toemail us, we love hearing from you!

Until next time,

Mariam and Airin

[email protected]


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ACT!on Social Determinants of Health

by Shela Putri Sundawa

One of these days I found an old book published byWHO in the year 1977 titled Global Strategy Healthfor All by 2000. As I kept reading the book, therewere a lot of questions I could not answer. This is 2012and I dont feel like anything closer to health for all.

From 1977 to 2012, if we talk about human beings, I be-lieve they have grown up to be adults right now. I wasonly born in 1989 and now Im a university student. So

lets imagine if this Global Strategy proposed by WHOwas a human being, he would be 12 years older thanme. He probably graduated from medical school, thencontinued to study cardiology and hes a cardiologistright now. 35 years is a long time. However he might beraised in a poor neighborhood. His dad was a drunk-ard and his mom left him when he was two years old.He never finished high school and his main job is drugdealer. One day police caught him and now hes impris-oned. 35 years is a long time. Everything can change in35 years, change to be better or change to be worse.

One of the major changes in the world during the last 35years is the population. From 1975 to 2000, the popula-tion in South East Asia Region increased by 61%. It meansby the year 2000, every country in South East Asia re-gion should have increased every public facilities, food,housing, clean water, and etc to accommodate the 61%increase.1 Failure to provide them might contribute a newpopulation problem which can lead away from achiev-ing health for all by 2000. How can a country provide

health for all if it cannot contend peoples basic needs?

The other population problem which needs to be focusedon is the changing population proportion. Population lessthan 15 years of age has declined 8% from the 1975-2000,while population aged 65 years and above has increased1.2% in South East Asia.1 This proportion changing can beexpected to shift the health problem from communicablediseases to non communicable diseases (NCDs). Of the57 million global deaths in 2008, 63% were due to NCDs.

Indeed, it is one of the barriers to achieving health for all.

When WHO proposed health for all by 2000 in 1977,they dreamed that health issues would be integrated withother policy such as, the economy. However until today,

the year of 2021 the problem to seek for health care inevery country is still the same as 35 years ago:, cold,hard cash. Primary health care which was declared asthe fundamental cornerstone of health care in the AlmaAta declaration in the year 1978 has only done a halfof its job. Why half? Because the main problem withprimary health care is the lack of facilities. In a studydone by Gadallah et al., about patient satisfaction withprimary health care in Egypt, shows that patient satisfac-

tion is high for accessibility, waiting area conditions andperformance of doctors and nurses while availability ofprescribed drugs, laboratory investigations and privacy inthe consultation room are unsatisfactory.2 This is the coreproblem which later will keep us away from achievinghealth equity as one of Alma Ata declaration principles.

National Social Economy Survey held in Indonesia re-vealed that only 34% of sick people will seek help by goingto a primary health care facility, while 25% will directly goto a doctor practice, 10% to a hospital (public and private),and the rest (31%) will go to a non-medical practice. Thisdata shows that primary health care is still not the choice ofmost people. There are still a lot of people who will seek non-medical treatment for their diseases. The inequity is there.

Therearestillalotofpeoplewhostillseekhelptononmedicaltreatmentfortheirdiseases.Theinequityisthere.

The main barrier to be considered in this problem is prob-ably the health care system of the country. Countries likeIndonesia where out-of-pocketspending accounts formore than a third of all

These people do not covered by any kind of healthinsurance. Ironic, isnt it? Compared to UK who applynational health system and provide national insurance for

health spending,has an overallwide accept-ance to useprivate sectorproviders for arange of healthservices andproducts evenamong the poor-est socioeco-

nomic groups.


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all of its citizens,3 the inequity about seeking whether touse medical treatment or non-medical treatment is never aproblem. To further compare the health indicator betweenthese countries shows that from infant mortality, maternalmortality and life expectancy UK is ahead of Indonesia.

However, since 1977 until today there are also a lotof things that have been achieved. The expanded pro-gramme on immunisation has succeeded to decreasethe number of infant mortality by protecting childrenfrom polio, measles, diphtheria, pertussis, TB, and tet-any. Some countries have considerably strengthenedtheir health services, establishing a network of facilitiesand making health care available close to where peo-ple live. Also, the success treatment of TB, which once

time. Perspective of social determinants of health is nota new approach, as the Alma Ata Declaration impliedit in the Primary Care Strategy. However, a lot of im-provement is still needed to develop the programme.

The main barrier to get a proper health care is finance. Pri-mary health care has solved the problem since the healthcare is very cheap. However many of the primary healthcare services still lack facilities and human resources. In In-donesia, primary health care in a remote town, for exam-ple Jayapura, only has 22 general practitioners whereasin Jakarta, the capital city, there are 12,000 general prac-titioners.5 This example shows how health care is not welldistributed in Indonesia. This condition might be not muchdifferent in similar continental country like Philippines.

What can be seen from here might be the spirit to elimi-

nate health inequity and disparity that has been existedsince a long time ago.declared as global emergency by WHO, has been in-creased by 50% than earlier before DOTS implementation.

Indeed there are a lot of things that has been achieved ifwe look back to 1977. But still, there are a lot of things thatneed to be done. The core principles declared in the AlmaAta declaration still remain a principle that has not been

successfully applied, Universal access and coverage onthe basis of need; health equity as part of developmentoriented to social justice; community participation in defin-ing and implementing health agendas; and intersectoralapproaches to health.4 Back in 1978, member states whojoined this declaration all agreed and did not object to whatwas declared. However 35 years from the declaration,the implementation for this declaration can hardly be seen.Health inequity and disparity still exist around the world.

What can be seen from here might be the spirit to eliminatehealth inequity and disparity that has existed for a long

Lets do the real act on social determinants of health!

References1. South-East Asia Progress Towards Health For All 1977-2000. World HealthOrganization Regional Office for South-East Asia. New Delhi: Facet. 2000.2. Gadallah M, Zaki B, Rady M, Anwer W, Sallam I. Patient satisfaction with

primary health care services in two districts in Lower and Upper Egypt. La Revuede Sant de la Mditerrane orientale, Vol. 9, NO 3, 2003.3. Health care system in transition. United Kingdom. 1999.4. World Health Report. Health system: principle integrated care. World HealthOrganization. 20035. Database Puskesmas. Departemen Kesehatan RI. Avalaible in: http://www.

bankdata.depkes.go.id/puskesmas/public/report/

The availability of the health care is merely one of theimportant factor of social determinants of health. How-ever there still not enough solutions for this problem. Idont want to blame the government since they alreadyhad so many programmes to attract health care provid-ers especially physicians. As a medical students and afuture health care provider, we should have some aware-

ness and aim to not only work in a big famous hos-pital but also to have some will to foster the health ofevery people including them who live in remote areas.

I believe that in our deepest of hearts we still have the goodwill of why we want to be a doctor: to help people. Notonly people in a big city but also people in remote smallislands that are far away from our hometown. Whats thegood of educating people who are already smart? Whatsthe good of offering some medical advice to those who al-

ready have a private doctor? Lets do the real act on social

Shela Putri Sundawa

Marketing,Campaign and Advocacy Director2011-2012, CIMSA-Indonesia

Global Cancer Ambassador for IndonesiaIFMSA SWG on Health Disparity and Inequality

IFMSA SWG on NCD


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IFMSA Asia Pacific Region and AMSA-Philippines hold

Confab towards Transformative Medical Educationby Rudolf Kuhn

The remedy against... epidemics... in the future is, therefore, very easy and simple:education, with its daughters, liberty and prosperity

It must have been a realization short of epidemic pro-

portions when Dr. Rudolf Virchow, renowned physi-

cian and statesman, dubbed as the father of socialmedicine, foretold already as early as 1890 the vital

role social medicine would play as cure for epidemics.

Many years later, to be exact, on 19-21 Decem-

ber 2011, under similarly auspices probably, a trail-

blazing grassroots conference was held at the Uni-

versity of the Philippines Manila that sought to

tackle global health problems on a local perspective.

With the theme Towards a Transformative Medi-

cal Education for a Healthy Asia-Pacic Future the

workshop-conference aimed to allow participants gain

a deeper understanding of global health issues and

trends, specically the emerging disparity between the

traditional curricula of medical schools and the health

needs of the community they were intended to serve.

Gathering nearly 50 participants and volunteers from

more than eight medical schools in the Philippines and

from the Krishna Institute of Medical Sciences Univer-

sity in India, the three-day workshop-conference, co-

organized by The Think Global Initiative and the Asia Pa-

cic Region of the International Federation of Medical

Students Associations (IFMSA) and the Asian Medical

Students Association (AMSA) Philippines, was jam-

packed with various topics on the global health situation,

the current health workforce crisis, social determinants

of health, social accountability and student advocacy.

The rst day covered a lecture on the Foundations of

Global Health by Ramon Lorenzo Luis Guinto, IFMSA

Regional Coordinator for the Asia-Pacic and over-all co -ordinator of the said workshop-conference, which laid

down the basics for the following days of the conference.

The lecture provided an overview of the history of global

health and dened certain key principles of human rights,

social determinants of health and equity. Guinto, in his

lecture, pointed out that social determinants of health

were an important, but often neglected, aspect in the

cause of human disease leading to systematic inequities.

The next two lectures, delivered by Dr. Marilyn Lorenzo,

former director of the Institute of Health Policy and Devel-

opment Studies of the Philippines National Institute of

Health, dealt with the mismatch between the needs of rural

communities and the tertiary-care geared competencies of

graduates produced by many of the medical schools. Loren-

zo also noted the health inequities in the Asia Pacic region.

The afternoon, meanwhile, provided a chance for the

participants to gain a rsthand glimpse of the work-

ings of the local seat of power and prestige, the West-

ern Pacic Regional Ofce of the World Health Organi-

zation (WHO). Dr. Rodel Nodora, Technical Ofcer for

Human Resources for Health, discussed in his lecture

the role of the WHO as health conscience of the re-

gion. He also elaborated on some of the key ndings

of a landmark study that appeared in the 2010 is-

sue of The Lancet seeking to scale-up health profes-


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sions education to the demands of the times through

multi-sectoral instructional and institutional reforms.

The afternoon at the WHO also allowed for some light mo-

ments as the participants were allowed to lounge like the

health ministers of the region in the oval session room.

The next days scorching morning heat did not stop

participants from visitingGawad Kalinga, a community

development project. In their visit, participants learnedabout healthcare delivery in those impoverished ar-

eas and how understanding and learning from the

felt-needs of the community is the key in establishing

effective projects towards sustainable self-reliance. The last set of lectures by Dr. Elizabeth Paterno, director of

the University of the Philippines (UP) San Juan, Batangas

Community Health Development Program, and Prof. Jusie

Lydia Siega-Sur, dean of the UP School of Health Scienc-

es, contained selected lessons on the role of community

partnerships and not mere charity projects in trans-

forming medical education. Prof. Siega-Sur, furthermore,

shared from her experiences as member of the Training for

Health Equity Network (THEnet) which recently formulatedthe Global Consensus on Social Accountability of Medi-

cal Schools, a thematic approach that seeks to enhance

medical schools responsiveness to the health needs of

society and tackle the continuing brain-drain issue faced

especially by many developing countries, such as the Phil-

ippines, by a number of measures, including a step-ladder

curriculum in health professions education. The said step-

ladder curriculum banks on tight community integration

in ensuring the continuous commitment of their health

professionals and allowing them to seek further profes-

sional growth as midwifes, nurses and eventually Doctors

of Medicine. The successful curriculum has recently beenalso replicated in other countries such as Timor-Leste.

The last day ttingly concluded with an interactive work-

shop allowing participants to share their opinion on the

current status of medical education in the country and

transforming education towards being responsive and re-

sponsible 21st Century physicians. During the workshop,

plans were made to engage in a dialogue with the Associa-

tion of Philippine Medical Colleges, a network of the coun-

trys medical schools, to air the student-participants per-

spectives about the future of medical education. Of course,

none of the lofty plans should remain just that elusive

and neatly stacked on some drawing board therefore,

the participants vouched for their continuous commitment

in a symbolic ceremony. The said event is thus expected

to stir many more ripples and be truly transformative.

The lecture series continued at the University of the Philip-

pines, where Dr. Ramon Paterno, research faculty at the

Institute of Health Policy and Development Studies of the

National Institute of Health, delved further into the social

determinants and inequities of health. He also discussed inhis second lecture an approach towards universal health-

care plans in the Asia Pacic and emphasized learning from

success stories of ones neighbour countries; specically,

he mentioned Thailands booming healthcare sector. He

concluded his lecture on a thought-provoking note, asking

participants, What good it is to treat diseases only to bring

our patients back to the conditions that made them sick?

Dr. Edgardo Ulysses Dorotheo, project director of the South-

east Asia Tobacco Control Alliance (SEATCO), meanwhile,

shared out of his rich experiences at SEATCO in advocating

smoking cessation. His anti-smoking campaign also recent-

ly won him the 2011 Judy Wilkenfeld Award for Internation-

al Tobacco Control Excellence. Dorotheo also encouraged

students in starting their own advocacies with the help of

a 9 Advocacy Questions approach developed by SEATCO.

social determinants of health were animportant, but often neglected, aspect inthe cause of human disease leading to

systematic inequities.


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PUTTINGPATIENTS SAFETY FIRST(Manila, Philippines) The World Health Organization

(WHO) recently launched the very first Multiprofes-

sional Patient Safety Curriculum Guide starting herein the Western Pacific Regional Office in Manila. This

auspicious event was attended by leading professionals

and deans of schools from the fields of medicine, phar-

macy, nursing, dentistry, and midwifery. AMSA-Philip-

pines was privileged to be part of the guest list in the

said event. The current president of AMSA-Phillipines

Joanna Marie Choa and former External Vice Presi-

dent Miguel Dorotan attended the event, representing

the voice of the medical students in the country. Held

on 19 October 2011 at the world-class Marriott Hotel

in Pasay City, this launching programme-workshop wasunder the initiative of WHO Western Pacific Regional

Office (WHO-WPRO), in cooperation with the Philippine

Alliance for Patient Safety (PAPS) and the Philippine

College of Surgeons. Distinguished guest speakers and

health officials from different countries such as Ja-

pan, Vietnam, Singapore, Cambodia, Laos, China, and

many others, also graced the event and shared their

insights regarding the policies governing patient safety.

tion of the guide into each healthcare fields curriculum

starting at the earliest possible year of study. Aside from

focusing on the benefits and advantages of having in-

troduced the topic at a very early stage, the speakers

also gave much emphasis on how to tackle the limita-

tions, obstacles, and difficulties that may arise from it.

Pledges from the participants were sought and acquired

as each representative was requested to sign the proc-

lamation supporting the curriculum. Closing the morn-

ing session with a concise summary was Dr Madeleine

Valera of the WHO-WPRO Patient Safety Programme.

The afternoon session was dedicated to a focused

group workshop and discussion on the opportunitiesand obstacles to implementing the multidisciplinary

patient safety curriculum. Strategies on how to enhance

opportunities and how to overcome the obstacles

were also brainstormed by each group of profession-

als. Participants were divided into their own fields and

subsequently presented their outputs to the assembly,

and were given opinions and comments from the ex-

perts. Interactive discussions and learning from the key

promulgators of the curriculum was also done by each

group. WHO Representative in the Philippines Dr Soe

Nyunt-U gave the concluding message to the programand left the crowd with motivating messages to take

home with. It was a truly enriching experience for all the

professionals convened in this very successful event and

was a good opportunity to share ideas with colleagues

from the different healthcare professions that were in

attendance.

Advice for students from attending this event is to put

the needs and safety of their patients as the top priority,

and to be careful and focused on what they are doing in

the hospital.

Dr Hans Troedsson, Director of the Division of Pro-

gramme Management WHO-WPRO, inspired the audi-

ence with a passionate welcome address. This was fol-

lowed by messages from the Department of Health and

from the Commissioner on Higher Education Professor

Nona S. Ricafort. Sir Liam Donaldson, envoy for patient

safety of WHO, sent in a video clip of his message for this

event, focusing on the aims of the formulated workshop

and sharing his vision for the outcome of this event. No-

table specialists on the field of patient safety and the key

persons who formulated the curriculum were Dr Agnes

Leotsakos from the Patient Safety Programme WHO-

HQ in Geneva, Prof Merrilyn Walton from New South-

Wales Australia, and Ms Stephane Newell represent-ing

the WHO Patients for Patient Safety. They discussed

important points and issues regarding the incorpora-

AMSA-PHILIPPINESRepresentativesJoannaChoaandMiguelDorotanwithrepresentativesfromthemedicaleld

AMSA-PHILIPPINES Representatives with professionals from theelds of medicine, dentistry, nursing, pharmacy, and midwifery

For more information, visit the website: http://www.who.int/topics/patient_safety/en/

by Joanna Marie D. Choa


11/1811

Center of Indonesia Medical Student Ac- tivities (CIMSA) represented Indonesias

medical students at this conference. CIMSAmembers who attended this conference joined

Student Session with other students from

other health professions. Together, they were

called the HPEQ Student. Parallel to this session,

policy makers, deans, and lecturers attended

their own sessions based on their professions,

such as Medical Sessions, Dentistry Ses-

sions, and other sessions. Of 150 students

who attended the Students Session, 33 of

these were from CIMSA. Futhermore, there was

2.000 participant who attended this conference.

The Student Session was officialy opened by arepresentative from Indonesias Ministry of Na-

tional Education and World Bank on December

3rd 2011. Then, Samuel Josafat as the chief from

HPEQ Student give a report from last years con-

ference and the progress of HPEQ Student in 2011.

(Samuel Josafat served as CIMSAs Liaision Of-

ficer for Ministry of National Education in 2009-

2010 and Vice President of External Affairs in

2010-2011.)

This year Student Session discussed two topics,which were curriculum accreditation and inter-

professional education. Curriculum accreditation

was presentated by Robert Duvivier, while inter-

professional education was presented by Sarwo

Bekti, MD and Mr. Mariyono Sedyowinarso. Af-

ter each presentation, there was discussion and

role play about the topics that were discussed.

(Robert Duvivier served as Vice President of the

European Medical Students Association in 2006-

2007. In 2008 he was elected Liaison Officer on

Medical Education issues to the executive board

of the International Federation of Medical Stu-

dents Associations (IFMSA). In this capacity he

represented medical students on the executive

board of the Association for Medical Education

in Europe (AMEE) and on the executive council of

World Federation of Medical Education (WFME).

He worked with the World Health Organization

(WHO) in their Reference Group on Medical Edu-

cation as expert consultant in 2010. Sarwo Bekti,

MD is lecturer in Faculty of Medicine Brawijaya

University, Indonesia and member of Indonesias

Medical Education Association. Mr.Mariyono

Sedyowinarso is lecturer in Faculty of MedicineGadjah Mada University, Indonesia.)

Main idea of the discussion about curriculum

acreditation was What is role of student in cur

Report from 2ndHealthProfessionalEducationQuality

International Conference

From 3rd to 5th of December 2011,

the 2nd Health Professional Edu-cation Quality (HPEQ) Interna- tional Conference was held inBali, Indonesia. This 2nd HPEQ In-

ternational Conference is a part of

HPEQ Project which is supported

by Ministry of National Educa- tion, Republic of Indonesia andWorld Bank. This conference wasattended by policy makers, deans,

lecturers, and students from all

across Indonesias health profes-

sions faculties. There are seven

groups health of professions in the

HPEQ Project: medicine, dentistry,public health, pharmacy, nutri- tion, midwifery, and nursery.

riculum acreditation? Nowadays, Indone-

sian education uses competency-based cur-

riculum and student-centered learning. Basedon this method, students must act as a subject

of education, not as an object of education.

However, students participation in curriculum

in Indonesia still relatively low. Policy mak-

ers and many faculties in Indonesia stiil do

not involve Indonesian students, during cur-

riculum making, implementation, and evaluation.

During this session, we took a look at European

Medical Students Association which produced

European Core Curriculum Students Perspec-

tive in 5th International Follow-Up Conference

on the Bologna Process in Medical Education,which was held in the United Kingdom in 2006.

This declaration later accepted by the United

Europe as a part of their policy and nowadays,

many European countries, based on this policy,

enter students participation in curriculum de-

velopment. This experience which was told by

Robert himself was really inspiring and gave us

a role model about student contribution in their

education, especially curiculum development.

In discussion about interprofessional education,

we had a discution and role play about How in-terprofessional education (IPE) be executed in real

situation? Currently, health professions educa-

tion in Indonesia still doesnt include IPE in their

curricullum, meanwhile in real-life situations

they must work together. So, in this session, stu-

dents tried many models in which IPE be execut-

ed, such as joint lectures, case discussions, joint

practicums, etc. The conclusion is there are still

many models and systems about how IPE can be

implemented in curriculum, but its very important

to include IPE in health professions education.

Thats all that Indonesian health profession stu-

dentshave done in the Student Session at the

2nd HPEQ International Conference. The end of

this conference wasnt meant that the work

has been done, but its just the start of the jour-

ney. Indonesias health professions curriculum

is still developing, but I am sure that this con-

ference is a good start for the development. All

we need is the experience and the opportunity.

by Christopher Christian Halimkesuma

Christopher Christian Halimkesuma

Liaison Officer for Ministry of NationalEducation - CIMSA Indonesia

University of Indonesia


12/1812

NZMSA Conference 2012 will challenge you to

contemplate what you will aim to achieve with

your knowledge; in your career, and in your life.

Applications for international students have now

opened and will close on March 27th, 0:00 (NZST).

For more information on the application process,

please visit http://conference.nzmsa.org.nz/inter-

national-applicants

New Zealand Medical

Students Association

present s:NZMSA

The New Zealand Medical Students Association (NZM-

SA) is excited to announce that applications have now

opened for international medical students to attend

the largest and most ambitious event in NZMSA his-

tory - NZMSA Conference 2012: Catalyst for Change.

The annual Conference began in 2006 as the Medi-

cal Leadership Development Seminar, but has sincebroadened in its breadth and scope to become

the flagship event of the NZMSA, and the high-

light of the New Zealand medical student calendar.

In 2012, 240 medical students from New Zealand

and the Asia-Pacific will be selected with one com-

mon goal; to unite together and work towards be-

coming the instruments of change in our generation.

The 2012 NZMSA Conference will

be hosted from May 18th-20th

in Rotorua - the tourism capital

and cultural hub of New Zealand.

It is an ideal opportunity for inter-

national students to travel to New

Zealand and enjoy the breathtak-

ing landscape made world-famousby the Lord of the Rings trilogy.

An inspirational academic programme

has been built around the five main pil-

lars of Clinical Leadership, Healthy

Equity, Global Health, Professional

Well-BeingandCommunity Empower-

ment.Featuring keynote presentationsand interactive breakouts by speakers

from across New Zealand and the

globe, delegates will be encouraged to

re-evaluate their privileged positions

as the future leaders of the health

profession; and to realize that our

Be t he change you want

t o see in t his wor ld Mahat ma Gandhi

The registration cost is ap-

proximately NZD$200 and

will be finalised upon receipt

of application. This covers ac-

commodation on 18th-19th

May, most meals and entry

to an unforgettable social pro-

gramme showcasing the best

that New Zealand has to offer.

NZMSA Conference 2012: Catalyst for ChangeDate: 18th-20th May 2012

Location: Rotorua, New Zealand

Website: http://conference.nzmsa.org.nz

Email: [email protected]

duty as physicians in the 21st

century is not only to provide

care for our patients, but also

to be the leaders in taking ac-tion towards securing better

health and wellbeing for our

local and global communities.

We look forward to welcoming youto Rotorua, New Zealand!


13/1813

Medical Students Association of India (MSAI) is

not merely a random association in the Republic

of India, but an association that many medical stu-

dents need and dreamt about. MSAI is designed

in such a way that it mirrors IFMSA as a whole

and at the same time brings all the Indian Medi-

cal Students under a single umbrella. MSAI priori-

tises events that are not only beneicial for the or-

ganisation itself, but also for the citizens of India.

18 months ago, the word IFMSA was quite unfamil-

iar until Tani Kahlon from IFMSA Grenada intro-

duced it to us. Honestly, we were skeptical about

its existence in India and the idea of establishing

it just died down. Not long after that, we received

another email from Mariette, a student from Tamil

Nadu State in India, which was so inspiring andsince then there was no turning back and we have

worked tirelessly towards our objectives and aims.

Within months, we came up with what we call as

The Executives and started building our team

(which has the cream of students). Today, we have

spread the word of IFMSA and MSAI to almost eve-

ry corner of the country and right now we have al-

most 4000 medical students as members from 92

different medical schools across India. Some of ourrecent milestones include our interview by Student

-BMJ which featured in last Octobers SBMJ. We

have organized numerous events and workshops

in India in favour of public health and also sent two

delegates to the Think Global Workshop in Manila

Say Hello to....

last December even though we were just a NMO

candidate for IFMSA. In the upcoming time, we

will be hosting our irst International Interactive

Workshop with the theme of, Global Health &Medi-

cal Education, for Better Public Health Standards in

Developing Nations - Towards a Better Tomorrow

for which we have conirmed participation from

6 countries so far and looking forward for more.

We are very excited about our candidature as an

oficial NMO of IFMSA on March Meeting 2012.

We are very optimist that the Republic of In-

dia will make it this time and will continue en-

during its hand of support to all other NMOs in

IFMSA. We are looking forward to meet all of

you in Ghana and lastly as the saying goes Athi-

ti Devo Bhava which simply means Guest isGod - we welcome you to the Republic of India!

MSAI - India

Kuldeep Shah & Archit Adhikar i, MS

AI

delegat es f or Think Global Ma

nila


14/1814

Gl o ba l Hea lt h Eq u it y

RoleofFutureHealthcareProfessionalin

AdvocacyandPolicy

Advocacy is not an unfamiliar concept to the medi-cal profession. Physicians, by nature, act as advocates

for individual patients taking extra steps to look aftertheir health needs. Indeed, our profession never keepsus far from engaging in policy, as we have done somany times in the past, advocating for harmful healtheffects of cigarette smoke, nuclear weapons, ozonedepletion and leaded petrol. As global health ineq-uity continues to grow in recent decades, it becomesever more important to recognize health as an essen-tial human right and to realize the underlying socialdeterminants that violate this right.1 This shift in ourreality and thinking calls for a movement from indi-

vidual and single-issue based advocacy to collaborat-ed public advocacy for the root causes of poor health.

As future healthcare professionals, we witness suf-ferings daily and inevitably come face-to-face withthe shadowy, oppressive and omnipresent social de-terminants that hide behind and stage pathologies.There is a compelling call for future healthcare pro-fessionals to not only be excellent clinicians but alsoinstigators of healthy social and political change, cur-ing pathologies of society. As Virchow puts it, Physi-

cians are the natural attorneys of the poor and social problemsfall to a large extent with their jurisdiction. Medicine is asocial contract and we hold social accountability.2

The American Medical Association denes physician

advocacy asaction by a physician to promote those so-cial, economic, educational, and political changes thatameliorate the suffering and threats to human healthand well-being.3 The rationale for medical student ad-vocacy is many-fold. Firstly, we have responsibility as

future doctors and as youth. Secondly, we are trained inevidence-based, precise and scientic thinking. Last-ly, as future doctors we possess public trust, accessto policy maker and a certain leverage in inuence.4

by Rennie QinAs young people, we are much more attuned to theunique social, economic and environmental problems

that face our society in the 21st century. Few oth-ers possess the same energy, ideas and passion forsocial change. Our values and thinking ultimatelyshape that of the future society. Over the past cen-turies, the values of our society has changed drasti-cally through anti-slavery, civil rights, anti-apart-heid, womens suffrage movements and more. Theliberalization and enlightenment of today is thehuman right-based movement of development andglobal health equity. In his theory of social change,German philosopher Hegel suggests that the status

quo thesis will encounter an anti-thesis converg-ing to a new status quo the synthesis. Develop-ment and global health equity is the anti-thesisreaction to the global order of today. It is a tide ofchange. And young people are at the fore-front of it.

Physicians are the natu-

ral attorneys of the poor andsocial problems fall to a largeextent with their jurisdiction.

Virchow


15/1815

Achieving global health equity is impossible with-out addressing the underlying international eco-nomic governance, political governance andstructural injustice. It is a problem too grave forhealthcare professionals to ignore and just leaveto our policy makers and economists. It is a prob-lem too urgent for youth not to step up as leaders

today. Fortunately, todays young doctors and stu-dents like to span between the world of rich andpoor1, to have re in their bellies [for advocacy].

The problem, therefore, is how. How do we achievehealth professional advocacy? First of all, we have torecognize that medical students already have a pen-chant for community work and charity, all is needed

As the 1st ever DA for advocacy, policy and education, I will

work hard to set up a lot of the groundwork for these goals.

Excited about advocacy? Join the Asia-Pacfc Think Tank which

will lead our region's eforts in global health advocacy.

is to add an advocacy theme to these work. The initialstep we must take is to equip ourselves with academ-ic knowledge of global health problems and skills incampaigning, advocacy and policy. As young people,we will do what we are best at taking innovative ac-tions and creative stunts to mobilize the public andmedia. We will call for the inclusion of global health

and advocacy training into medical school curriculaand internship programs. We will use our skills andknowledge in focused advocacy on a wide range of he-alth issues. We will run high impact advocacy cam-paigns and engage stake holders to create concrete so-cial, political and institutional change. We will createa culture of advocacy leading to global health equity.

References

1. Farmer PE, Furin JJ, Katz JT. Global Health Equity. Lancet; 363(9423):1832.2. Wen LS, Greysen SR, Keszthelyi D, Bracero J, de Roos PDG. Social Accountability in Health Professionals Training. Lancet;

378(9807):e12-3.3. Association AM. Declaration of Professional Responsbility: Medicines Social Contract With Humanity.4. Earnest MA, Wong SL, Federico SG. Perspective: Physician advocacy: what is it and how do we do it? Academic Medicine; 85(1):63-7.

Rennie Qin is a 2nd year medical student from the Univer-sity of Auckland, New Zealand. She is DA for advocacy, policyand education for IFMSA Asia-Pacific, Medical Students for Glob-al Awareness MSGA Auckland coordinator and climate changecampaign national coordinator. She is passionate about glob-al health, advocacy, environment, development and travelling.


16/1816

Theme: ClimateChange and Health

The deadline for article submisson is April, 8th

2012.So, dont waste your time! Start think-ing and writing now!

And by the way, everything in life is writableabout if you have the outgoing guts to do it andthe imagination to improvise. The worst enemy

to creativity is self-doubt.

-Sylvia Plath

The social determinants of health are the conditions in which people are born, grow, live, work

and age, including the health system. These circumstances are shaped by the distribution of

money, power and resources at global, national and local levels, which are themselves influ-

enced by policy choices. The social determinants of health are mostly responsible for health ineq-

uities - the unfair and avoidable differences in health status seen within and between countries.

So its our responsibility , young people as the agent of change to

Act on Social Determinant of Health!for the brighter future, for the better world!

Write for our May Issue!

Articles should be sent as Word (.doc or .docx) le attach-

ment:[email protected]

Also if you have any questions please dont hesitate to

contact us.


17/1817

Be A Part of Us!Pulse is IFMSA magazine for Asia Pacific. Pulseis a way for medical students from very dif-

ferent countries to connect with each oth-

er and share their stories and opinions.

FromAsiaPacific,

Contributors by writing any articles relating totheme, a health issue, an NMO updates, project

updates, conference report, or anything else that

matches our requirements.

Contact our Development Assistant for Publications

and Communications (Mariam & Airin):

Editors by helping our editorial team to edit arti-cles that have been submitted to us.

Proofreaders by helping our proofreading teamto proofread articles that has been submitted to us.

Respondents Starting in our next issue, we willprovide a new segment called Whats Up Asia

Pacific?!and you can simply join us to share yourideas, thoughts, opinions, projects, or anything else

throughout the region in an informal way (less seri-ous and lesser words than article). This segment will

contain polls, opinions, and photos that have been

submitted online by people all over the Asia Pacific

region.

Join us and become one of our:

[email protected]

toAsiaPacific,byAsiaPacific!

Interested?

1. Manuscripts are to be submitted via email to da.pub.ifmsa.

[email protected] as an attached electronic document.

2. The email should include the full name of the author (as they would

like it to appear in print), their university and their NMO/Country.

3. The subject of the email should include the words Pulse Article,

and the authors name. A small photo of the author may also be

submitted to accompany the article in print.

4. All articles must be written in English.

5. Articles should be no longer than 700 words and use standard type

fonts (eg. Times New Roman, Calibiri).

6. Articles should have spelling and grammatical checking prior to

submission, however as English is a second language for many in the

region we have a team of proof-readers who can check your article

and provide English and editing assistance prior to writing.

7. Photos and tables are encourages. These should be submitted

separate to the article with a brief description. Photos taken from

external sources must be referenced appropriately, and the author

should have approval to use them. Photos should be sent as a

separate attached file in .JPG form and in good resolution!

8. References to external publications are not necessary however if they

are used then they must be references according to the Vancouver

Referencing System. References must be cited in the sequential order

in which they appear in the text. All references should be cited in

text with a number following the reference. At the end of the article

references should be numerically listed in the order they appear in

the article.

Author Guidelines


18/18

www.ifmsa.orgdi l d ld id

Algeria (Le Souk)Argentina (IFMSA-Argentina)

Armenia (AMSP)Australia (AMSA)

Austria (AMSA)Azerbaijan (AzerMDS)

Bahrain (IFMSA-BH)Bangladesh (BMSS)

Bolivia (IFMSA Bolivia)Bosnia and Herzegovina (BoHeMSA)

Bosnia and Herzegovina - Rep. of Srpska (SaMSIC)Brazil (DENEM)

Brazil (IFMSA Brazil)Bulgaria (AMSB)

Burkina Faso (AEM)Burundi (ABEM)Canada (CFMS)

Canada-Quebec (IFMSA-Quebec)Catalonia - Spain (AECS)

Chile (IFMSA-Chile)China (IFMSA-China)

Colombia (ASCEMCOL)Costa Rica (ACEM)Croatia (CroMSIC)

Czech Republic (IFMSA CZ)

Denmark (IMCC)Ecuador (IFMSA-Ecuador)

Egypt (EMSA)Egypt (IFMSA-Egypt)

El Salvador (IFMSA El Salvador)Estonia (EstMSA)Ethiopia (EMSA)Finland (FiMSIC)France (ANEMF)

Georgia (GYMU)Germany (BVMD)Ghana (FGMSA)

Greece (HelMSIC)

Grenada (IFMSA-Grenada)Hong Kong (AMSAHK)

Hungary (HuMSIRC)Iceland (IMSIC)

Indonesia (CIMSA-ISMKI)Iran (IFMSA-Iran)

Israel (FIMS)Italy (SISM)

Jamaica (JAMSA)Japan (IFMSA-Japan)

Jordan (IFMSA-Jo)Kenya (MSAKE)

Korea (KMSA)

Kurdistan - Iraq (IFMSA-Kurdistan/Iraq)

Kuwait (KuMSA)Kyrgyzstan (MSPA Kyrgyzstan)Latvia (LaMSA Latvia)Lebanon (LeMSIC)Libya (LMSA)Lithuania (LiMSA)Luxembourg (ALEM)Malaysia (SMAMMS)Malta (MMSA)Mexico (IFMSA-Mexico)Mongolia (MMLA)Montenegro (MoMSIC Montenegro)

Mozambique (IFMSA-Mozambique)Nepal (NMSS)New Zealand (NZMSA)Nigeria (NiMSA)Norway (NMSA)Oman (SQU-MSG)Pakistan (IFMSA-Pakistan)Palestine (IFMSA-Palestine)Panama (IFMSA-Panama)Paraguay (IFMSA-Paraguay)Peru (APEMH)Peru (IFMSA Peru)Philippines (AMSA-Philippines)

Poland (IFMSA-Poland)Portugal (PorMSIC)Romania (FASMR)Russian Federation (HCCM)Rwanda (MEDSAR)Saudi Arabia (IFMSA-Saudi Arabia)Serbia (IFMSA-Serbia)Slovakia (SloMSA)Slovenia (SloMSIC)South Africa (SAMSA)Spain (IFMSA-Spain)Sudan (MedSIN-Sudan)Sweden (IFMSA-Sweden)

Switzerland (SwiMSA)Taiwan (IFMSA-Taiwan)Tatarstan-Russia (TaMSA-Tatarstan)Thailand (IFMSA-Thailand)The former Yugoslav Republic of Macedonia (MMSA-Macedonia)The Netherlands (IFMSA-The Netherlands)Tunisia (ASSOCIA-MED)Turkey (TurkMSIC)Uganda (FUMSA)United Arab Emirates (EMSS)United Kingdom of Great Britain and Northern Ireland (Medsin-UK)United States of America (AMSA-USA)Venezuela (FEVESOCEM)

pulse march 2012 issue

Documents